Pathological formations that developed for no apparent reason by multiplying cells. They are distinguished by polymorphism of the structure and detached growth. True tumors have a number of features that distinguish them from similar formations in external signs. So, they should be distinguished from the swelling, which is a symptom of diseases such as cyst, goiter, etc., also occur in hematomas, dropsy, various inflammatory processes and injuries.
Reactive swelling of tissues, the body after the elimination of the causes disappears. The onset of the development of a tumor always continues, as if going out from under the regulatory action of the organism, since it has the “autonomy” of growth.
Tumor qualities can occur in the cells of any body tissue that is capable of reproduction. Becoming a tumor, the original cell transmits new properties to its direct cellular descendants, which become similar to it in their morphological and chemical characteristics, manifestation of a number of regularities.
According to the features of growth and clinical course, benign and malignant formations are distinguished.
Benign tumors grow slowly, surrounded by a capsule, do not germinate, and pushing adjacent tissues and organs. Depending on the location, such a tumor in some cases can exist throughout the life of the patient, without causing him much harm. In other cases, during its growth, it puts pressure on a nearby organ, causes its atrophy, squeezing blood vessels and nerves. A benign tumor does not metastasize and after it is glad to cure, it is cured (does not recur).
Malignant tumors are characterized by rapid infiltrative growth, they are not delimited from the neighboring tissues by the capsule and, germinating, destroy them.
The cells of malignant tumors, growing into lymphatic and blood vessels, can be torn off and flow of fluid (blood, lymph) into other organs, causing the development of new tumors - metastases. The growth of a cancerous tumor in the body changes the metabolism, causing a deterioration of the general condition, a dramatic depletion and dystrophy. The beginning of its development is often asymptomatic, which leads to late treatment of patients and delay in diagnosis. The infiltrating ability to spread creates difficulties in establishing the boundaries of the lesion, which makes it necessary to remove not only the tumor during surgery, but also the surrounding healthy tissue, which may contain cancer cells. However, after this, a relapse may occur again in the same place.
The division of tumors into benign and malignant is conditional and permissible only in the clinical evaluation of the disease. Since benign, but located near vital organs and impair their function, can lead to the death of the patient (brain tumors, mediastinum, etc.).
Examination of a patient with suspected tumor should answer first of all the following questions: 1) there is a patient patient who has a true tumor or an education for it is a symptom of another disease; 2) a benign or malignant tumor, whether there are metastases; 3) is it possible to remove the tumor, i.e. whether there is a technical (anatomical) and functional operability. Answers to these questions are obtained after a detailed clarification of complaints, the history of the disease and clinical, endoscopic, radiological, pathophysiological and other special methods of examination.
Symptoms and course:Benign tumors usually do not cause complaints and are often found by chance, on the internal organs, they appear only as symptoms of mechanical disruption of their activity. The general condition of the patient, as a rule, does not suffer. When examining a superficially located formation, the roundness of its shape or the lobulation of the structure draws attention. The tumor is mobile, not soldered to the surrounding tissues, its consistency may be different, regional lymph nodes are not enlarged, palpation is painless.
The onset of the development of a malignant tumor proceeds hidden for the patient himself, and meanwhile, early diagnosis is important. In this regard, when examining individuals, especially over 35 years old, about vague complaints, started losing weight, long-term ongoing continuous and increasing symptoms of the disease for no apparent reason should show oncological suspicion. This concept includes: 1) suspicion of the presence of cancer, 2) careful collection of anamnesis, 3) use of general and special research methods; 4) deep analysis and synthesis of the materials obtained for the diagnosis.
Often, patients with a malignant neoplasm complain about a violation of the general condition: loss of normal tone in work, apathy, lack of appetite, nausea in the morning, weight loss, etc. This may be joined by more local symptoms - the presence of chronic stomach disease mammary gland, etc. At first, these phenomena may not be accompanied by pain, but then, when the tumor begins to grow into the nerve trunks, pains appear that take on an increasingly painful nature. Cancer grows fast. Substances for feeding the cells come from the whole body, causing them to be deficient in other tissues and organs. In addition, despite the large number of blood vessels in a cancer, their inferiority often leads to malnutrition in certain parts of it and their breakdown. Necrosis products are absorbed into the body, leading to intoxication, progressive emaciation, exhaustion, cachexia.
Recognition:In the history pay attention to chronic diseases, the profession of the patient, bad habits. After a general examination of the patient, groping the size of the tumor (if available), its character, texture and attitude to the surrounding tissues. The presence of ulcerations, distant metastases, and an increase in regional lymph nodes are determined.
When examining hollow organs (intestines, gall, bladder, etc.), endoscopy is widely used, which is performed by endofibroscopes with an optical system and illumination. It provides an opportunity not only to examine a suspicious part of an organ, and to take a piece for histological examination. Biopsy (excision) followed by microscopic examination is a very valuable method of oncological diagnosis. In case of a disease of internal organs, when, despite all the research methods used, the diagnosis remains unclear, but the suspicion of the tumor process is not removed, they resort to a diagnostic operation (celiac section, thoracohomia, etc.) to determine the nature or extent of spread Processes.
Prevention:It has now been established that some tumors develop on the soil of various long-lasting inflammatory and other diseases of the organs. For example, in chronic anacid gastritis, chronic kaleznoy ulcer and gastric polyps over time, stomach cancer may develop. Chronic bronchitis and long-term recurrent interstitial pneumonia precede lung cancer. Long-lasting non-healing fissures and ulcers, increasing pigment spots, growing warts, papillomas and hyperkeratosis precede skin cancer. All this made it possible to create a study on pretumor, precancerous diseases, the detection and treatment of which is the basis of cancer prevention.
Surgical treatment of a benign tumor: excision with a capsule followed by histological examination. For small and superficially located, not disturbing the patient, waiting is possible. The absolute indications for its removal are: 1) the presence of a symptom of organ compression, obstruction, the cause of which is the tumor; 2) permanent injury to the clothes of a superficial tumor; 3) growth acceleration and suspicion of malignant degeneration.
Treatment of malignant tumors depends on the stage of the disease. The formed tumor focus is initially limited to an organ or tissue, but later on, due to germination into the surrounding tissues and metastasis of the tumor cells, the process is generalized. In this regard, there are four stages of the development of the disease: Stage 1 - a localized process; Stage II - damage to nearby (organ) lymph nodes; Stage III - the defeat of the regional lymph nodes; Stage IV - the presence of distant metastases.
Malignant tumors are subject to immediate radical surgical treatment. The operation consists in the complete or partial excision of a tissue or organ together with a developed tumor and fiber with regional lymph nodes.
However, the opportunity to perform such a radical operation is only possible in patients with stages 1 and II of the process, less often in patients with stage III due to the presence of distant metastases and their germination in vital organs.
In recent years, the operational method has been widely combined with X-ray and radium radiation, with hormone therapy. Began to apply chemical and biological methods of treatment.
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